Palmer notation (sometimes called the "Military System" and named for 19th-century American dentist Dr. Corydon Palmer from

Warren, Ohio Warren is a city in and the county seat of Trumbull County, Ohio, United States. Located in northeastern Ohio, Warren lies approximately northwest of Youngstown and southeast of Cleveland. The population was 39,201 at the 2020 census. The h ...

) is a dental notation (tooth numbering system). Despite the adoption of the

FDI World Dental Federation notation FDI World Dental Federation notation (also "FDI notation" or "ISO 3950 notation") is the world's most commonly used dental notation (tooth numbering system). It is designated by the International Organization for Standardization as standard ISO ...

(ISO 3950) in most of the world and by the

World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level o ...

, the Palmer notation continued to be the overwhelmingly preferred method used by orthodontists, dental students and practitioners in the

United Kingdom The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain, is a country in Europe, off the north-western coast of the European mainland, continental mainland. It comprises England, Scotlan ...

as of 1998. The notation was originally termed the Zsigmondy system after Hungarian dentist

Adolf Zsigmondy Dr. Adolf Zsigmondy, aka Adolph Zsigmondy (24 April 1816 in Pozsony (german: Pressburg), Kingdom of Hungary – 23 June 1880 in Vienna, Austria-Hungary) was a dentist of Hungarian origin who lived in Vienna. He is best known for inventing the ide ...

, who developed the idea in 1861 using a Zsigmondy cross to record quadrants of tooth positions. Adult teeth were numbered 1 to 8, and the child primary dentition (also called deciduous, milk or baby teeth) were depicted with a quadrant grid using Roman numerals I, II, III, IV, V to number the teeth from the midline. Palmer changed this to A, B, C, D, E, which made it less confusing and less prone to errors in interpretation. The Palmer notation consists of a symbol (⏌⎿ ⏋⎾) designating in which quadrant the tooth is found and a number indicating the position from the midline. Adult teeth are numbered 1 to 8, with deciduous (baby) teeth indicated by a letter A to E. Hence the left and right maxillary central incisor would have the same number, "1", but the right one would have the symbol "⏌" underneath it, while the left one would have "⎿".

Table of codes

Orientation of the chart is traditionally "dentist's view", i.e. patient's right corresponds to notation chart left. The designations "left" and "right" on the chart, however, nonetheless correspond to the patient's left and right, respectively. One advantage of Palmer notation is that it can produce a very graphical image, akin to a 'map' of the dentition; tooth transpositions or edentulous spaces can easily be depicted if desired. It would also be feasible to introduce additional alphabetic characters or other symbols, for example to denote

supernumerary Supernumerary means "exceeding the usual number". Supernumerary may also refer to: * Supernumerary actor, a performer in a film, television show, or stage production who has no role or purpose other than to appear in the background, more commonl ...

teeth or bridge pontics, to which a purely numerical method such as the FDI system does not lend itself easily.

Computerization

With the move from written dental notes to electronic records, some difficulty in reproducing the symbols has been encountered. On a standard keyboard 'slash' and 'backslash' may be used as a crude approximation to the symbols with numbers placed before or afterwards; hence 3/ is ³⏌ and /5 is ⎾₅. The Miscellaneous Technical block in

Unicode Unicode, formally The Unicode Standard,The formal version reference is is an information technology standard for the consistent encoding, representation, and handling of text expressed in most of the world's writing systems. The standard, ...

provides Palmer notation symbols in U+23BE through U+23CC. The symbols are not to be confused with

box-drawing characters Box-drawing characters, also known as line-drawing characters, are a form of semigraphics widely used in text user interfaces to draw various geometric frames and boxes. Box-drawing characters typically only work well with monospaced fonts. ...

(┘└ ┐┌), which have the horizontal line at the middle. These symbols are inherited from JIS X 0213 Dentist symbols. Daniel Johnson has put together a Palmer Tooth Notation TrueType font called FreePalmer. It is covered by the GPL 3 license. This font is descended from

FreeSans GNU FreeFont (also known as Free UCS Outline Fonts) is a family of free OpenType, TrueType and WOFF vector fonts, implementing as much of the Universal Character Set (UCS) as possible, aside from the very large CJK Asian character set. The ...

. It can be used in

OpenOffice OpenOffice or open office may refer to: Computing Software * OpenOffice.org (OOo), a discontinued open-source office software suite, originally based on StarOffice * Apache OpenOffice (AOO), a derivative of OOo by the Apache Software Foundation, ...

and other software. A "MP7" derivative which enables the grid patterns to be produced that correspond to handwritten Palmer tooth notations is available for download as well. The FreePalmer characters are placed in the

Latin-1 ISO/IEC 8859-1:1998, ''Information technology — 8-bit single-byte coded graphic character sets — Part 1: Latin alphabet No. 1'', is part of the ISO/IEC 8859 series of ASCII-based standard character encodings, first edition published in ...

part, overriding existing characters. A more technically correct way would be to program

orthographic ligature In writing and typography, a ligature occurs where two or more graphemes or letters are joined to form a single glyph. Examples are the characters æ and œ used in English and French, in which the letters 'a' and 'e' are joined for the first ...

s into the font.

Victor Haderup notation (Danish variant)

The Danish dentist

Victor Haderup The name Victor or Viktor may refer to: * Victor (name), including a list of people with the given name, mononym, or surname Arts and entertainment Film * ''Victor'' (1951 film), a French drama film * ''Victor'' (1993 film), a French shor ...

devised a variation of the Palmer notation where the (⏌⎿ ⏋⎾) symbols are replaced by plus/minus signs, which can either be placed in front or behind the number. A plus (+) indicates upper position while minus (−) indicates lower. When the sign is in front of the number, it indicates left while after it indicates right. For instance −6 indicates the 6th lower left tooth, i.e. first mandibular molar.

References

Sources

* {{cite web , author=Bunn S , title=Tooth Numbering , url=http://www.drbunn.com/faq/tooth-numbering , date=19 May 2006 , accessdate=2010-04-21

External links